Apoptosis, or programmed cell death, is a cell suicide process with a major role in development and homeostasis in vertebrates and invertebrates. Dysregulation of apoptosis leading to early cell death or the absence of normal cell death contributes to a number of disease conditions including neurodegenerative diseases and cancer. Inhibition of apoptosis enhances the survival of cancer cells and facilitates their escape from immune surveillance and cytotoxic therapies. Inhibitor of apoptosis (IAP) proteins, a family of anti-apoptotic regulators that block cell death in response to diverse stimuli through interactions with inducers and effectors of apoptosis are among the principal molecules contributing to this phenomenon. IAP proteins are expressed in the majority of human malignancies at elevated levels and play an active role in promoting tumor maintenance through the inhibition of cellular death and participation in signaling pathways associated with malignancies. Herein, the role of IAP proteins in cancer and strategies toward targeting IAP proteins for therapeutic intervention will be discussed.